Drug boosts body's receptivity to Vitamin D

Patients taking interferon-beta, a drug for multiple sclerosis (MS), received almost three times as much vitamin D from sun exposure than those not taking the treatment, say new findings.

MS is an autoimmune disease that damages the brain and spinal cord (central nervous system). There is currently no cure, but treatments are available to ease some of the symptoms.

MS is caused by damage to the myelin sheath that protects nerve cells.

This damage causes the nerve signals to slow down or cease. Inflammation occurs when the body's own immune cells attack the nervous system. This can affect any area of the brain, optic nerve, and spinal cord, journal Neurology reports.

This observational analysis by the Menzies Research Institute Tasmania, based on data from 178 MS patients, suggests that one of the main treatments for MS may also increase the amount of vitamin D patients receive from sun exposure.

Around 60 percent of MS patients are treated with interferon-beta. Derived from a naturally-occurring component of the human immune system, the drug has been found to reduce the frequency of relapse and other specific symptoms of MS, according to a statement of Menzies Institute.

Steve Simpson Jr, who co-authored the study with Niall Stewart from Menzies, said the findings suggest that part of the therapeutic effects of interferon-beta on MS may be through its effects on vitamin D, since it has the ability to reduce inflammatory pathways in the immune system.

"Not only did we find that persons taking interferon-beta had higher vitamin D levels than those not taking it, we also found that this increase in vitamin D was due to an enhancement of the association between sun and vitamin D, with persons on interferon-beta having nearly three-times as much vitamin D from similar amounts of sun exposure to those not taking interferon-beta," Simpson said.

"We have previously shown persons with MS with higher vitamin D levels had lower numbers of relapses. In this analysis, however, we found that vitamin D was only associated with reduced risk of relapse among those using interferon-beta," said Simpson.

Source - Times of India

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What's a better option - angioplasty or bypass?

What would you choose - angioplasty or bypass? This question has cropped up after Uddhav Thackeray from Maharashtra's most popular political family had to choose between angioplasty or bypass.

While a layperson often confuses between the two, there is some merit in deciphering this debate even amongst our health professionals. Today, Interventional Cardiologist with Medanta-The Medicity at Gurgaon, Dr. Nishant Tyagi, helps us understand the difference between angioplasty and bypass.

If you have blocked arteries, the doctor would suggest angioplasty or bypass. These are two options in front of you, but what does this mean? Angioplasty involves passing a tiny tube through the artery from the groin. The blocked arteries are cleaned out and a 'wire-mesh tube is placed in the artery to help keep it open, allowing blood to flow freely through the heart again.'

Dr. Tyagi says, "Angioplasty is treating the blockages in the coronary arteries that supply the heart by passing a very small balloon over a wire and inflating it and then putting a stent there in a similar way to open the blockage. It's done via access through groin or wrist and doesn't require open heart surgery or general anesthesia. The procedure takes only ~ 1hour and patient can go home in 2 days and get back to work in a week."

A bypass on the other hand involves surgically grafting veins that will change the blood flow away from the clogged area in the artery. Bypass surgery involves operating when the heart is stopped and is stabilized with a pump.

Dr Tyagi explains this complex procedure: "While bypass surgery is a surgical procedure, which requires general anesthesia and opening the chest and rib cage to treat the blockages in the coronary arteries by creating bypass tracts from patients own arteries of veins from the legs to bypass the blockages. The surgery requires 4 hours and patient is usually discharged in 7-10 days and get back to work only after 2-3 months."

Complex and final as this might sound, an angioplasty or bypass is not a permanent solution. You still have to change your diet and follow an exercise routine to burn excess fat and cholesterol. These surgeries are not a hall-pass to eating junk food. "They are not permanent solutions and no one should have that feeling. It just gives another chance to an individual to change his life style so that blockages don't appear again which includes Quit smoking, regular exercise, eat health food, keep cholesterol under check with cholesterol lowering drugs. The blockages might come again in the same area which has been treated or another area with time. Newer drug eluting stents have a 3-4% or chance of recurrence at the same site. Venous grafts in bypass also degenerate with time and 50% degenerate in a decade while 90% show degeneration in 15 years. So these are just temporary solutions," reminds Dr. Nishant.

So the question remains, which procedure is a better option for you? Our cardiologist does not hide the truth; he suggests there is a debate at play. He says, "To answer this question, both the surgeon and interventions have there own opinion. There are scientifically made scoring systems of the blockages eg: SYNTAX score, which have been used to find out what is better for which patient. Still most of the decisions are taken up by the treating clinicians and patient wishes and there profile."

He delves deeper into this perplexing issue, "Half the cases fall into black and white area where decision is simple like - if there are 1-2 short blockages in 1-2 arteries Angioplasty is better. If there are multiple long blockages in all 3 or left main arteries, bypass is better. Then rest of the cases come in the grey area where the decision is difficult as both can be done but depends on - comorbidities (presence of one or more diseases) of the patient like lung condition to sustain a long surgery and general anesthesia. If lungs are not good, a bypass is difficult and so angioplasty is done. Then there are patients who don't wish to get an open heart surgery and leave work for 3-4 months and so an angioplasty is offered. There is also a financial issue - drug eluting stents come from Rs. 55,000 - Rs.1,25,000 and so if multiple are deployed then cost of the procedure increases considerably whereas most cases of bypass are done in 1.5 - 2.5 lakhs."

Finally here are some useful tips for post surgery recovery. Cardiologist, Dr. Nishant suggests some solutions: "There is a list of rehabilitation and secondary prevention measures to come back into the normal routine with a better life style. We call them lifestyle measures, which are almost similar to those we recommend for primary prevention.
Quit smoking as this is most important.
Diet should be good in fruits and vegetables, avoid all fried stuff, avoid saturated fats eg: butter, ghee, dairy products.
Good control of blood sugars and blood pressure with medication.
Control of cholesterol with medications.
Regular exercise - brisk walking for 3-4 km in 30-40 minutes.
Yoga and meditation.
Regular follow up for all this with cardiologist every 3-6 months."

Source - Times of India

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Many unaware of HBV vaccine

Various estimates suggest that in our country, there are 20 to 25 million Hepatitis B virus (HBV) positive persons and another 10 million Hepatitis C virus (HCV) positive cases. The irony, doctors assert, is that a majority of such persons are unaware that they are infected resulting in a silent HBV infection.

Gastroenterologists regret that many are unaware about the existence of a HBV vaccine and there is no age limit for its administration. Any person who has tested positive for HBsAg, which is usually done during routine blood tests, should opt for a simple liver function test to ascertain whether they are inactive HBV carriers.

“Inactive carriers are those who have HBV virus in their body but the viral DNA level is less than 2,000 International Units. Such persons do not have inflammation of liver and liver function is normal. However, they should careful because once their immunity levels drop, then HBV simply emerges,” says Head of Gastroenterology and Hepatology department, Yashoda Hospitals, Dr. B. Ravi Shankar.

So what is hepatitis? Hepatitis is inflammation of liver due to viral infection. There are four types of hepatitis that include A, B, C, D and E. Of the four, types B and C cause chronic liver diseases and lead to liver cirrhosis and cancer. Usually, the type D virus occurs with HBV and doctors maintain that HBV vaccination will be enough to keep the type D at bay.

Doctors maintain that spreading awareness on various hepatitis, causes, symptoms and cure among general public is important. “Doctors should spread awareness about these viruses. General public should know that vaccine exists for Hepatitis A and B. Awareness very important,” says Dr. Ravi Shankar.

Mainly, Hepatitis A and E are caused due to exposure to polluted water and food and vaccination for hepatitis A is available. “Many tend to compare hepatitis B with HIV. This should not be done. Adults should opt for screening for hepatitis virus. Hepatitis B and C are mainly is transmitted through blood transfusions, contaminated injections during medical procedures, transmission from infected mothers to children is also possible,” doctors said.
Source - The Hindu

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कैंसर के इलाज में सहायक नई रक्त कोशिका की खोज

लंदन। वैज्ञानिकों ने एक नई सफेद रक्त कोशिका की पहचान का दावा किया है। यह सफेद रक्त कोशिका रोग प्रतिरोधक क्षमता को सक्रिय करने का काम करती है जिससे शरीर बाहरी आक्रमण से लड़ने में सक्षम होता है। शोधकर्ताओं का दावा है कि यह कैंसर के इलाज में विशेष तौर पर कारगर सिद्ध होगी। न्यूकैसल और सिंगापुर के शोधकर्ताओं ने दावा किया है कि ये सफेद रक्त कोशिकाएं जीवाणु, विषाणु आदि के हमले होने पर शरीर को सुरक्षा प्रदान करती हैं। यह कोशिका टी कोशिकाओं को सक्रिय करने का काम करती हैं। इस प्रक्रिया को क्रॉस प्रेसेन्टेशन कहा जाता है। न्यूकैसल यूनिवर्सिटी के वरिष्ठ शोधकर्ता डॉक्टर मुजलिफाह हनिफा ने बताया कि इन सफेद रक्त कोशिकाओं का प्रयोग हम कैंसर के विरुद्ध टीके बनाने में कर सकते हैं। यह अध्ययन इम्यूनिटी नामक पत्रिका में प्रकाशित किया गया है।

Source -Jagran

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